GNM 3rd Year | Obstetrics & Gynecology | Paper I

 

---

Home Academy – Model Answers

GNM 3rd Year | Obstetrics & Gynecology | Paper I

---

Q1. Enumerate internal organs of female reproductive system and describe structure and functions of uterus.

Internal organs of female reproductive system

1. Ovaries

2. Fallopian tubes (Uterine tubes)

3. Uterus

4. Cervix

5. Vagina

---

Uterus – Structure

The uterus is a hollow, pear-shaped muscular organ situated in the pelvic cavity between the bladder and rectum.

Parts of uterus

1. Fundus – upper dome-shaped part

2. Body – main central portion

3. Isthmus – narrow middle part

4. Cervix – lower narrow neck opening into vagina

Layers of uterus

1. Perimetrium – outer covering

2. Myometrium – thick muscular layer

3. Endometrium – inner lining

---

Functions of uterus

Site for implantation of fertilized ovum

Nourishes and protects fetus during pregnancy
Contracts during labour for delivery
Menstrual shedding in absence of pregnancy
Helps in expulsion of placenta after birth

---

Q2. Enumerate 4 physiological changes in normal pregnancy and describe any one in detail.

Four physiological changes

1. Increase in size of uterus

2. Increase in blood volume

3. Breast enlargement

4. Hormonal changes

---

Detailed explanation – Uterine changes

During pregnancy the uterus enlarges from a pelvic organ to an abdominal organ.

Weight increases from about 60 g to nearly 1000 g

Muscle fibres hypertrophy
Blood supply increases
Capacity increases to accommodate fetus, placenta, and liquor amnii

This change supports fetal growth and labour.

---

Q3. Describe in detail process of fertilization and implantation.

Fertilization

Fertilization is the union of male and female gametes.

Process

Occurs in ampulla of fallopian tube

Sperm penetrates ovum
Nuclei fuse
Zygote is formed
Cell division begins

---

Implantation

Implantation is the attachment of fertilized ovum to uterine wall.

Steps

Zygote divides into morula

Changes into blastocyst
Reaches uterus in 4–5 days
Embeds in endometrium on 6th–7th day

This starts pregnancy.

---

Q4. Describe management of first stage of labour.

The first stage starts from onset of true labour pains till full dilatation of cervix.

Management

Admit patient and maintain privacy

Record vital signs
Assess contractions
Check fetal heart rate
Monitor cervical dilatation
Maintain asepsis
Encourage fluids if allowed
Provide emotional support
Empty bladder regularly
Prepare labour room articles

---

Q5. Describe care of a pregnant lady suffering from pre-eclampsia.

Pre-eclampsia is hypertension with edema and proteinuria after 20 weeks pregnancy.

Nursing care

Monitor BP regularly

Check urine for albumin
Observe edema
Bed rest in left lateral position
Administer antihypertensive medicines
Give prescribed magnesium sulfate
Monitor fetal movement
Restrict salt if advised
Watch for convulsions

---

Q6. Management of puerperal sepsis and puerperal psychosis

Puerperal sepsis

Infection after delivery.

Management

Maintain hygiene

Antibiotics as prescribed
Monitor temperature
IV fluids
Adequate nutrition
Perineal care

---

Puerperal psychosis

Severe mental disturbance after childbirth.

Management

Ensure mother and baby safety

Psychiatric consultation
Medicines as prescribed
Family support
Rest and nutrition

---

Q7. Menstrual cycle and any two disorders

Menstrual cycle

Normal cycle lasts 28 days.

Phases

1. Menstrual phase

2. Proliferative phase

3. Ovulatory phase

4. Secretory phase

---

Two disorders

Amenorrhea

Absence of menstruation

Dysmenorrhea

Painful menstruation